INTRODUCTION: Otitis media with effusion(OME) is mainly a disease of childhood. But it can also occur in adults. It can present with various symptoms like difficulty in hearing, blocked sensation of ear, earache and tinnitus, often diagnosed late due to lack of awareness among the guardians or inability of the children to express the hearing difficulty, and often diagnosed accidentally. AIMS AND OBJECTIVES: The aim of this study is to assess and compare the effectiveness of grommet insertion with myringostomy to the non–surgical management of OME in childhood and adolescent age group. MATERIALS AND METHODOLOGY: 96 patients suffering from OME documented with otoscopy, pure tone and impedance audiometry, were studied from February 2014 to January 2016 in the ENT Department. 48 patients were put on medical management whereas the rest were subjected to myringostomy –grommet insertion. Both the groups were evaluated based on the parameters of hearing level and duration of middle ear effusion. RESULTS: Patients undergoing medical management showed a mean improvement of pure tone air conduction threshold of 5.47 ± 2.35 dB while it was 8.77 ± 2.15 dB in patients subjected to myringostomy and ventilation tube insertion. CONCLUSION: Surgical intervention has proved to be a better option of treatment, with established statistical significance, as shown in the study and early management with ventilation tube insertion would benefit these subjects in reducing learning difficulty in early school life.